Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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A Large Hematoma Due to Benign Ulcer Perforation of the Gastric Fundus Resembling Submucosal Tumor

점막하종양으로 오인된 위 저부 양성궤양 천공으로 인한 거대혈종 1예

  • Kim, Nam-Yong (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Oh, Jung-Hwan (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Choi, Soo-Jin (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Kim, Seung-Kyoung (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Song, Youn-Mi (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Jie, Byung-Soo (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Oh, Seung-Hyun (Department of Internal Medicine, The Catholic University of Korea College of Medicine) ;
  • Choi, Sang-Wook (Department of Internal Medicine, The Catholic University of Korea College of Medicine)
  • 김남용 (가톨릭대학교 의과대학 내과학교실) ;
  • 오정환 (가톨릭대학교 의과대학 내과학교실) ;
  • 최수진 (가톨릭대학교 의과대학 내과학교실) ;
  • 김승경 (가톨릭대학교 의과대학 내과학교실) ;
  • 송윤미 (가톨릭대학교 의과대학 내과학교실) ;
  • 지병수 (가톨릭대학교 의과대학 내과학교실) ;
  • 오승현 (가톨릭대학교 의과대학 내과학교실) ;
  • 최상욱 (가톨릭대학교 의과대학 내과학교실)
  • Received : 2010.02.13
  • Accepted : 2010.06.13
  • Published : 2010.09.30
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Abstract

The gastric fundus is a rare site for benign ulcer and perforation to occur. A 47 year-old male presented to the emergency department with epigastric pain. An endoscopic examination revealed a submucosal tumor-like lesion with friable, superficial ulceration in the high body of the stomach. We performed surgical resection to rule out malignancy because of the lesion's large size and we found chronic gastric ulcer perforation, which was pathologically diagnosed. We presumed that the formation of the large hematoma, which mimicked a submucosal tumor, was a result of repeated bleeding, perforation and healing. We report here on a case of a large hematoma due to a benign gastric ulcer perforation in the fundus, and this all mimicked a submucosal tumor.

위 저부는 소화성궤양이 잘 생기지 않으며, 천공의 호발 부위가 아니다. 47세 남자가 상복부 통증으로 내원하였다. 상부 위장관 내시경검사에서 위 저부와 위체부 중상부에 걸쳐 있는 10 cm의 종괴가 관찰되었다. 그 종괴는 정상 점막으로 덮인 융기된 병변과 함께 표면의 발적, 출혈과 표층의 궤양을 가지고 있어 위 점막하 종양을 의심하여 수술적 절제를 시행하였다. 수술소견과 조직학적 확진을 통해 만성위궤양의 천공에 의한 혈종으로 밝혀졌다. 궤양의 호발 위치에서 벗어나 생긴 궤양이 출혈과 미세한 천공, 수복이 반복되면서 거대 혈종의 형태로 병변이 발전한 것으로 생각한다. 저자들은 상부위장관 내시경 검사에서 점막하종양과 구분하기 어려웠던 위궤양천공에 의한 혈종 1예를 보고한다.

Keywords

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